Prolonged duration of transbrachial intra-aortic balloon pump as bridge to heart transplantation

We describe a case demonstrating the quality of life (QOL) benefit and safety of using a transbrachial approach for insertion of an intra-aortic balloon pump (IABP) in a patient awaiting cardiac transplantation. A 68-year-old man with ischaemic cardiomyopathy was admitted to our cardiac intensive ca...

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Bibliographic Details
Published in:BMJ case reports 2015-02, Vol.2015, p.bcr2014208658
Main Authors: Smith, Triston B B J, Shridhar, Puneeth, Khalil, Ramzi, Lasorda, David Michael
Format: Article
Language:English
Subjects:
Aged
Brachial Artery
Catheters
Coronary vessels
Family medical history
Flow velocity
Heart failure
Heart Failure - surgery
Heart Transplantation
Heart-Assist Devices
Humans
Hypertension
Intra-Aortic Balloon Pumping
Male
Myocardial Ischemia - surgery
Novel Treatment (New Drug/Intervention
Established Drug/Procedure in New Situation)
Patients
Preoperative Care - methods
Prosthesis Implantation - methods
Quality of Life
Transplants & implants
Treatment Outcome
USA/Canada
Veins & arteries
White
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Summary:We describe a case demonstrating the quality of life (QOL) benefit and safety of using a transbrachial approach for insertion of an intra-aortic balloon pump (IABP) in a patient awaiting cardiac transplantation. A 68-year-old man with ischaemic cardiomyopathy was admitted to our cardiac intensive care unit to await the availability of a suitable donor organ for orthotopic heart transplant. An IABP was needed for haemodynamic support due to cardiogenic shock. Since the patient did not want to be committed to lying supine in bed for multiple days, as would have been the case had the IABP been placed using the conventional femoral route, we inserted a 7.5 Fr ‘sheathless’ IABP via the transbrachial approach. The patient's haemodynamics improved and the device was left in place for 240 h without vascular compromise. He was subsequently successfully transplanted and is doing well on follow-up.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2014-208658